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09/03/2012 20:12 <br />SITE A�pRESS <br />3 yo o, <br />LEGA LpTNO: <br />DESC. <br />c����/s <br />TENANT NAME <br />CONTR. L"ICENSE li <br />USE OF BUILDING <br />��� <br />:.:'i'__'- . �' i . <br />l�cRMI.T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR�STREET, EVERETT, WA 98201 <br />425-257-881 b- FAX 425-257-885T — www,everettwa.org <br />APPUCA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />' /vc <br />'G � �. <br />BLOCK . TRACT <br />' ' pRE <br />' 3Yo �/,;��„ <br />PARCEI. 7A7( I.p: R.. <br />� � <br />R SU�pryIS10N 1�, <br />i • <br />ai�� !,� <br />CONiACT FOR PERMIT <br />.a : <br />RE <br />.5k�s D� 5;-.�r.� .. ,36'0/ <br />9�/SSo�zrsz � <br />� <br />� <br />aov5s P.00i/oo2 <br />9 �oN -�Z <br />PERMIT 8 <br />✓�tavq - vv� <br />�z.f- z.s 7-�l�, <br />� � � � � � GIT7/Z!P . . PXONE - - <br />,���i-+e- �fzr z>��a/G/ <br />. . . . ...._ . . . <br />�� 9�io/ <br />HEAT 60URCE . ' CONTRACT PRICE OF WORK <br />� . � e�ecvic �'c�es � oa,ar : Z�op �" <br />WORKpESCRIPTION� ' ' <br />�� � �'a; �,.�„� <br />N0. <br />. ...�...: �. <br />PLUMBING <br />TYPE OF FIXTURE OR 1T6M .. —I ...-. �' <br />Toilet <br />� 6ath�ub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Ctothes washer <br />Watar �eater <br />� Sink (service/baz/mop/etc.) <br />_ Backtfow preventer <br />Urinal <br />_ Orinking Fountain <br />Floor drain <br />Grease Vap <br />Roo( drains <br />T Other _ <br />...__......^, . <br />_. ._ �_r_ ._....__._.. . . <br />, :.1.�_._ �.':i•�. . .. . <br />N0. <br />... ., �.�. <br />.. _. TYpE OF FUCTUItE OR ITEMI <br />AIC– alf handling units <br />ForcW afrcystems <br />Gat pipirq <br />Wafer heAror <br />QaS�IfAj11lG� � <br />c3as ranqs <br />Cbthet dryer <br />Ran9� hood � <br />F�aust hn �. �:;� . . <br />Heat pump ' <br />Unit h�obr • - <br />Boiler <br />RehipatiGon <br />WoalsWw <br />Otner <br />cRY Of EVERETT LOCAL 3ALES TAX CODE It NOS <br />I hereby ceriGfy thal I have read and examined thR applicatlon and k0ow the spms f0 b� We anC oancl. All provisiont of lawe and <br />ordinaces goveming thit type of work wlll be complie4 with wMIMr Rpac�fied henin ar rrot The anuttirq of a pertnit does not ptesume <br />to give authority to violate or cancel th� provfsion ot any otlkr ttal� orixal law repulatirg aonaWetion or th� p�rfortnance of <br />construction. That I am authorized by th� pwner oi ihis_property 10 p�rfomt {he work for vfikh appllCettOn is mad� and I oomply with ths <br />State Contrac �ay� 18.2 • and 296.2OO.VVAC.,! _ i <br />/iC � �i�-/L i .. <br />...-. _. . _ _ - .. .. . . . - : .� <br />.. � •: .. . . <br />i ..,�::. ,�,..., . <br />